scholarly journals Trajectory modelling of ambulatory care sensitive conditions in Finland in 1996–2013: assessing the development of equity in primary health care through clustering of geographic areas – an observational retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Markku Satokangas ◽  
Sonja Lumme ◽  
Martti Arffman ◽  
Ilmo Keskimäki
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Retrospective Study ◽  
Ambulatory Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Primary Health ◽  
Trajectory Modelling ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

scholarly journals Comparative research aspects on hospitalizations for ambulatory care sensitive conditions: the case of Brazil and Portugal

2020 ◽  
Vol 25 (4) ◽  
pp. 1375-1388 ◽  
Author(s):  
João Victor Muniz Rocha ◽  
João Sarmento ◽  
Bruno Moita ◽  
Ana Patrícia Marques ◽  
Rui Santana
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Comparative Research ◽  
Comparative Approach ◽  
Ambulatory Care Sensitive Conditions ◽  
Primary Health ◽  
Methodological Aspects ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Hospitalizations for ambulatory care sensitive conditions have been used to measure access, quality and performance of the primary health care delivery system, as timely and adequate care could potentially avoid the need of hospitalization. Comparative research provides the opportunity for cross-country learning process. Brazil and Portugal have reformed their primary health care services in the last years, with similar organizational characteristics. We used hospitalization data of Brazil and Portugal for the year 2015 to compare hospitalizations for ambulatory care sensitive conditions between the two countries, and discussed conceptual and methodological aspects to be taken into consideration in the comparative approach. Brazil and Portugal presented similarities in causes and standardized rates of hospitalizations for ambulatory care sensitive conditions. There was great sensitivity on rates according to the methodology employed to define conditions. Hospitalizations for ambulatory care sensitive conditions are important sources of pressure for both Brazil and Portugal, and there are conceptual and methodological aspects that are critical to render the country-comparison approach useful.

scholarly journals Are ambulatory care sensitive conditions a valid indicator for quality of primary health care?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Keskimäki ◽  
M Satokangas ◽  
S Lumme ◽  
V-M Partanen ◽  
M Arffman ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Hospital Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Care Organisation ◽  
Primary Health ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Background Hospitalisations due to ambulatory care sensitive conditions (ACSCs) have been used for assessing access to and quality of primary health care (PHC) in many countries. To assess the validity of ACSCs for assessing PHC performance we carried out a series of studies on regional and sociodemographic variations and time trends in ACSC hospitalisations and related mortality. Methods Hospitalisations due to ACSCs in Finland in 1992-2013 came from the national Hospital Discharge Register. The data were linked to population at risk data and individual sociodemographic indicators from Statistics Finland, and subsequently to area indicators of population health and socioeconomics, and health care organisation. Depending on study questions, we analysed ACSCs divided into acute, chronic and vaccine-preventable causes using appropriate statistical methods, such as multilevel Poisson models and trajectory modelling. Results We found ACSC hospitalisations to be highly associated to subsequent mortality with 4-10-fold excess 1-year mortality compared to the general population. ACSC hospitalisations showed substantial regional variations which declined over the study period due to decreasing variations in hospitalisations related to chronic ACSCs. The variations were mainly attributed to the hospital district level. In detailed analyses, about a quarter of the variance in ACSC hospitalisations was explained by individual level socioeconomic and health factors. In addition, population health indicators and factors related to hospital care organisation explained up to one third of the variance. Conclusions At patient level a hospitalisation due to ACSC is a sentinel event and associated to a high risk of poor health outcomes. However, using ACSC for benchmarking PHC providers should be addressed with caution and differences in sociodemographic factors and (co)morbidity of populations at risk, and regional heath and hospital care arrangements should be taken into account. Key messages Variations in hospitalisations due to ambulatory care sensitive conditions may mainly be linked to other factors than access to and quality of primary health care. More research is needed to validate ambulatory care sensitive conditions for use in assessing primary health care.

scholarly journals Assessment of primary health care from the perspective of patients hospitalized for ambulatory care sensitive conditions

2015 ◽  
Vol 33 (3) ◽  
pp. 243-248 ◽  
Author(s):  
Francisco dos Santos de Sá ◽  
Cláudia Di Lorenzo Oliveira ◽  
Débora de Moura Fernandino ◽  
Cristiane A Menezes de Pádua ◽  
Clareci Silva Cardoso
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Primary Health ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

The Concept and Usefulness of Ambulatory Care Sensitive Conditions as Indicators of Quality and Access to Primary Health Care

2007 ◽  
Vol 13 (3) ◽  
pp. 91 ◽  
Author(s):  
Zahid Ansari
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Ambulatory Care ◽  
Policy Implications ◽  
Ambulatory Care Sensitive Conditions ◽  
Primary Health ◽  
Proxy Indicators ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

The purpose of this review is to introduce health services researchers, especially in the area of primary health care, to the meaning and concept of ambulatory care sensitive conditions (ACSCs). More specifically, this review explores the validity of ACSC admissions as proxy indicators of access to primary health care, provides a description of the factors that cause variations in ACSC admission rates, and presents a discussion of the potential usefulness and policy implications of these indicators for primary health care. Critical Interpretive Synthesis (CIS) methodology was used to review the literature on ACSC admissions indicators. Medline and Australasian Medical Index were searched for English language articles published between 1970 and August 2005. The results were supplemented by an internet search of the World Wide Web, further augmented by manual scans of material from deeper levels within the sites. Main finding from the review indicates that ACSC admissions are valid proxy indicators of access to primary health care. Socioeconomic factors are most important in explaining variations in ACSC admissions. Several uses and policy implications of ACSC admission indicators are discussed, including their potential for identifying gaps in the primary health care system and providing opportunities for targeted public health and health services interventions.

scholarly journals SUBSTANTIATION OF COMPONENTS OF AVAILABILITY AND INTEGRATION OF PRIMARY HEALTH CARE ASSOCIATED WITH AMBULATORY CARE SENSITIVE CONDITIONS IN UKRAINE

2021 ◽  
Vol 74 (3) ◽  
pp. 584-588
Author(s):  
Valery N. Lekhan ◽  
Liudmyla O. Hrytsenko
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Action Plan ◽  
Ambulatory Care Sensitive Conditions ◽  
Family Doctors ◽  
Primary Health ◽  
The Impact ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

The aim: Identifying the components of availability of Primary Health Care (PHC) and integration between PHC and secondary Health care (SHC) which need strengthening to reduce the rate of Ambulatory Care Sensitive Hospitalizations (ACSH) in Ukraine. Materials and methods: The study was conducted in two stages: the focus of interviewing experts on the list of components of the availability of PHC and its integration with SHC; survey of our questionnaire is based on the results of the first stage of the study. The responses of 93 respondents – 20 experts and 73 general practitioners/family doctors – were analyzed using descriptive and analytical statistics. Results: There were identified 14 components of PHC availability and 8 integration components of PHC with SHC, their quantitative value (in points) of impact on ACSH. The informativeness of components is confirmed by the agreement of opinions of experts on their list (concordance coefficient W = 0.75 -0.87; p <0.01) and the reliable correlations of scores of impact assessments of the identified components with overall values of the impact availability PHC and the integration between PHC and SHC on the ACSH. Conclusions: The results of the study can be used to develop an action plan for reform of PHC, the implementation of which will reduce rates hospitalizations of Ambulatory care sensitive conditions and increase the efficiency use of limited resources of health care system of Ukraine.

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